Lumbar Spinal Stenosis Treatment: Is Surgery Better than Non-Surgical Treatments in Afro-Descendant Populations?

• Published in: Biomedicines Vol. 10; no. 12; p. 3144
• Main Authors: Louis-Sidney, Fabienne, Duby, Jean-Florent, Signate, Aïssatou, Arfi, Serge, De Bandt, Michel, Suzon, Benoit, Cabre, Philippe
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 06-12-2022; MDPI
• Subjects: afro-descendants; Analysis; Back pain; Back surgery; Body mass index; Clinical trials; Comparative analysis; conservative treatments; Decompression; Epidural; Health care access; Life Sciences; lumbar spine stenosis; Patients; Physical therapy; Self report; Spinal stenosis; Spine (lumbar); Stenosis; Steroids; Surgery; France; afro-descendants; lumbar spine stenosis; conservative treatments; surgery
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines10123144

(1) Background: Limited data are available on lumbar spine stenosis management in sub-Saharan African populations and Afro-descendant patients are underrepresented in European and US clinical trials. We aimed to compare the clinical response between decompressive surgery and conservative treatments in a population of self-reported Afro-Caribbean patients with lumbar spine stenosis over a 2-year follow-up period. (2) Methods: Prospective cohort of 137 self-reported Afro Caribbeans with lumbar spine stenosis based on clinical and radiological criteria. Patients were assigned to decompression surgery or to conservative treatments according to their outcome after a first course of steroid epidural injection and their preferences. The primary outcome was evolution of the Oswestry disability index at 3 months (3 M), 12 M, 18 M and 24 M follow-up. (3) Results: Decrease of ODI was significantly more important in the “decompression surgery” arm compared to “conservative treatment” arm at 3 M, 12 M and 18 M: −17.36 vs. 1.03 p < 10−4; −16.38 vs. −1.53 p = 0.0059 and −19.00 vs. −4.52 p = 0.021, respectively. No difference was reported at 24 M. (4) Conclusions: In this first comparative study between surgery and conservative treatments in an exclusively afro-descendant lumbar spine stenosis cohort, we report long term superiority of decompression surgery versus conservative treatments over an 18-month period.